If you had a condition that could cause you to go blind, you’d think you’d at least be aware of it. Yet half of the 3 million Americans with glaucoma have no clue their sight is at risk, according to the Centers for Disease Control and Prevention.
“Glaucoma can be completely symptomless in the early stages, so many patients don’t realize that they need to be checked for it,” says Jennifer Stone, OD, an optometrist and glaucoma specialist at Levin Eyecare in Baltimore.
But make no mistake: Glaucoma is serious. Behind cataracts, it’s the second-leading cause of blindness in adults 50 and older, according to a recent study in The Lancet. Here’s what you need to know to protect your eyes. (If you need medication for glaucoma, Optum Perks can help you afford it. Download our app to get started.)
What is glaucoma, exactly?
Your eye requires a certain amount of internal fluid to function. Glaucoma generally occurs when your eye fails to maintain a balance between the amount of fluid produced and the amount that drains away. As fluid builds up, so does pressure. And that can cause damage to the nerve in the back of the eye, called the optic nerve, explains Amanda Salter, MD, an ophthalmologist in Berkley, Michigan.
Over time, this damage can result in loss of vision. Usually people first experience fading peripheral vision. Untreated, the loss can creep inward. (If your vision is blurry, that could be a symptom of migraines.)
Who is most susceptible to glaucoma?
Anyone can get glaucoma. This is why regular eye exams are important even if you don’t have any obvious risk factors, stresses Dr. Stone. But certain groups are at higher risk. You’re more likely to get glaucoma if:
- You are over age 60.
- You are African American and over age 40. Black people are up to 8 times more likely to get glaucoma than Caucasians, according to the Centers for Disease Control and Prevention.
- You have diabetes. People with diabetes have twice the risk of glaucoma, according to the CDC. The disease affects circulation, so your optic nerve might not be getting as much blood flow as it needs, says Dr. Salter. The disease can also lead to the growth of new blood vessels in places that make it hard for your eye to drain fluid.
- You’ve had a past eye injury. Severe trauma, such as being hit in the eye, can increase eye pressure.
- Frequent steroid use. According to the American Optometric Association, long-term use of corticosteroids such as prednisone and hydrocortisone appear to increase the risk of glaucoma.
How do you know if you have glaucoma?
The only way to know for sure that you have glaucoma is with a complete eye exam. This is one reason the American Academy of Ophthalmology recommends all adults, even those without risk factors or vision problems, have a baseline comprehensive eye exam at age 40. After that, people with no increased risk should follow the academy’s schedule:
- 40 to 54 years old: every 2 to 4 years
- 55 to 64: every 1 to 3 years
- 65 or older: every 1 to 2 years
Those who do have an increased risk need more frequent screening. Talk to your eye doctor about the right schedule for you. During your eye exam, your doctor will do the following to check for glaucoma:
- Measure your eye pressure: Normal eye pressure is usually considered to be between 10 and 20 millimeters of mercury (mmHg).
- Inspect your eye’s drainage angle: This is the area of your eye that drains aqueous fluid, the clear liquid that keeps your orbs healthy. If it’s blocked, it can cause high eye pressure.
- Examine your optic nerve for damage
- Test your peripheral (side) vision
- Measure the thickness of your cornea
It’s important to remember that just 1 abnormal test result — for example, high eye pressure — doesn’t mean you have glaucoma. “These aren’t all thumbs-up or thumbs-down sort of tests,” says Dr. Stone. “We have to consider all the information together for the big picture.”
How is glaucoma treated?
There’s no way to undo damage already done to the optic nerve, says Dr. Salter. So the goal is to stop progression of the disease. “All the treatments work to lower your eye pressure to keep your disease stable and stop any further damage to the optic nerve,” says Dr. Salter.
Depending on how far along the disease is, your doctor may recommend the following:
- Prescription eyedrops. These are applied daily to lower eye pressure, either by reducing the amount of aqueous fluid your eye makes or improving your drainage angle. Download the Optum Perks mobile app to search for discounts on prescription eyedrops.
- Laser surgery. People with the most common form of glaucoma, called open-angle glaucoma, often undergo trabeculoplasty. With this procedure, your eye doctor applies a laser to your eye’s drainage angle so aqueous fluid can drain better. This is usually done in your eye doctor’s office or at an outpatient medical center.
- Surgery. There are several minimally invasive procedures, says Dr. Salter. But for more severe cases, your eye doctor may recommend trabeculectomy. In this procedure, the doctor creates a tiny flap in the white of your eye for aqueous fluid to drain through. In another version of the procedure, you may receive a tiny drainage tube in your eye.
Once glaucoma has been diagnosed and you’ve begun treatment, you’ll want to schedule check-in doctor appointments every 3 months or so, says Dr. Salter. But the exact timing will vary based on your situation. These appointments are critical to your recovery, so be sure to follow your doctor’s guidance.
